Nationally, 33% of Medicare Part D beneficiaries received a prescription opioid in 2016, with several states, many of them with large rural populations, having higher rates. The elderly are at serious risk for opioid dependence or other harms due to higher prescribing patterns. However, there is a lack of literature on the rural-urban difference in the use and misuse of prescription opioids. Understanding these differences will help rural areas better target prevention and treatment options.

We will address opioid prescribing rates among Medicare beneficiaries, using the Medicare Current Beneficiary Survey and describe differences in socioeconomic, health, and functional status of beneficiaries using prescription opioids and the general population using bivariate and logistic regression analyses. The impact of opioid use and medication-assisted therapy on health services utilization and costs will be assessed using difference in differences models.